Cervical Selective Nerve Root Block

Cervical selective nerve root block procedures are used to diagnose and treat neck pain resulting fromcervical radiculopathy. Radiculopathy refers to a compression of nerve roots that results in pain radiating along the nerves. Cervical radiculopathy is often caused by cervical spinal stenosis or a cervical disc herniation. Cervical spinal stenosis is an unhealthy narrowing of the spinal canal that sometimes pinches and irritates spinal nerves. Neck pain is caused by a cervical disc herniation when the bulging or damaged disc material presses against the nerves. Other disorders that contribute to cervical radiculopathy include bone spurs, repetitive stress, spinal injuries, scoliosis, and arthritis.

Woman with neck pain

Overview Of The Procedure

Patients can usually choose whether to receive an intravenous sedative during the cervical selective nerve root block procedure or to use local anesthetic only. The patient lies on his or her side to expose the neck and the treatment area is cleaned and sterilized. A local anesthetic is applied to numb the skin before the epidural needle is inserted into the neck. The needle is guided into the appropriate area using X-ray images and a contrast dye. Once the epidural needle is properly positioned, the affected tissue is bathed in a local anesthetic to disrupt the transmission of pain from nerve roots. A corticosteroid medication may also be applied to reduce nerve inflammation.


Patients should be driven home by a friend or family member after being released, especially if a sedative was used during the procedure. The patient should keep a detailed pain diary to assist our doctor in formulating a treatment plan. Pain may increase for a day or two after the anesthetic wears off but should be noticeably reduced within a week.

Benefits Of Cervical Selective Nerve Root Blocks

Patients should notice an immediate reduction in pain after the injection due to the local anesthetic. If a steroid was applied, the patient will experience additional pain relief as it begins to reduce inflammation. In addition to reducing pain levels, cervical selective nerve root blocks allow doctors to diagnose the exact cause of neck pain. If pain is significantly reduced by injections in a certain area of the neck, the nerves in that area can be identified as a major cause of the condition. If a nerve root block proves to be ineffective, the pain is likely being generated by factors that are unrelated to cervical nerve compression.

Possible Risks And Side Effects

Cervical selective nerve root block injections are generally safer than undergoing surgery, but they are not entirely free of risks. Puncture of the membrane that contains the spinal fluid occurs in a very small percentage of cases. These punctures lead to headaches and nausea that generally fade after a few days. The patient may be instructed to stop taking blood-thinning medications such as Coumadin a week before the procedure to prevent bleeding. Nerve damage, infections, and vascular puncture are other risks, although they happen infrequently.